About those kegels...
Updated: Jul 22, 2020
Unsure how to approach your return to training? This post is an intro to provide insight on how to navigate prenatal/postpartum exercise. With emphasis on the value of collaborating with a pelvic floor therapist.
Bottom Line Up Front (BLUF)
Ladies! Kegels are the most recommended pregnancy/postpartum (pp) exercise but let me tell you there is so much more we can do for the recovery of our vagina's. This post is dedicated to highlighting the concept of Postpartum Athleticism and key points I want you to walk away with.
1. Kegels - more than what meets the eye
2. The 6-8 week postpartum clearance means shit without a PFT
3. Shift your mentality
Kegels - more than what meets the eye
Am I even doing it right? I mean you can't coach me it's an invisible act. I'm supposed to be
secretly "kegeling" in random places. Or so I thought...I'm going to hope I'm not on my own
here, I thought I was doing a kegel correctly until I was evaluated. Essentially I was contracting really hard in my mind and my Pelvic Floor Therapist (PFT) felt nothing. Guess the urine stream trick, didn't do the trick...My point being I had to be trained to isolate that particular muscle via biofeedback, then I was able to focus on strengthening. My current PFT is a GOD send, I prayed for her and God delivered - DUH! If it wasn't 100% clear before (It hadn't clicked for me until baby #3) this is an entire group of muscles y'all. They contract, relax, you can perform myofascial release of trigger points, It's the real deal. So the kegel or the lifting of the pelvic floor is a component to always consider in every movement not the sole exercise to do when you randomly think about it. Heard of diastasis recti, the separation of the abdominal muscles? The pelvic floor seals the core. The pelvic floor must be challenged in different positions, within an appropriate timeline while regarding lifestyle. Another factor to be mindful of is athletes tend to have tight pelvic floors, their issue lies in appropriately relaxing those muscles. These concerns are the Pelvic floor therapists realm, this collaboration aligned with training is vital for us as athletes.
The 6-8 week postpartum clearance means shit without a PFT
Yea I said it, We wait 6-8 weeks (or we don't) for what we already know and want to hear, which is business as usual. But sorry Gur'friend I'm here to tell you this visit is important but it does not address you (mentally/physically) in regards to fitness. My athlete brain has me literally showing up to this appointment in workout gear ready to train because the time is now! YES, now is the time to...
a. Ask your provider for a consult with a Pelvic floor therapist
b. Walk it out
c. Hydrate/Eat mindfully
d. Adjust, accept your new reality, give yourself grace and time
Recall your postpartum visit for clearance, did your OB/Midwife evaluate you for a diastasis recti? Was a vaginal exam done to assess your pelvic floor? So on what grounds are we "good to go", because I said I'm doing good, not bleeding anymore and no complaints of pain...O.K.
Realize this, the approach to your vagina is very different from the lens of an OB/Midwife vs Pelvic Floor therapist.
Both are highly important but trained to address different concerns. The collaboration of these specialties would do more for women's health long term.
Shift your mentality
Everything is a challenge or watch me in an athlete's brain. My first pregnancy I was convinced all I needed was 2 weeks to get back in shape. In my 2nd pregnancy, 3rd trimester my midwife asked me if I was exercising I proudly said, "yea weight training and running no more than 5 miles". Proud for taking it easy but still staying fit. She followed with great, one of my patients is training for a half. I look at my husband like, Does she know who she's talking to... I had to talk that concept down for weeks. You are not about to run a half just so you can say you did it, 8 months pregnant...
Determine where the middle of the spectrum is for you. I didn't Identify with the handicapped version of pregnancy where people wouldn't allow you to lift a finger. I sure as hell identified with lets see what this pregnant body is made of. It is an active and ongoing battle to say just because I CAN doesn't mean I SHOULD. There is this lingering fear and said or unsaid expectation that drives us to get back to baseline. Reject it! Your body maintained this significant shift for 9 months lets give it the time it needs to heal. Not to mention the learning curve of integrating all the dynamics that have been disrupted - sleep, hormones, your routine. This is a major adjustment. I've approached this postpartum period differently, I'm not rushing. I do not fear if I'm capable, I am and so are you.
Training - Athletes have selective hearing
Whatever your desired fitness level is the foundation is the same your pelvic floor and abdominal muscles must be addressed. Again, See a Pelvic floor therapist, advocate for yourself this is a valuable asset. Everyone's timeline with a PFT will vary but an evaluation can give you major insight."Intention now for intensity later", Brianna Battles of the Pregnant and Postpartum Athlete. She doesn't even know me, but she's changed my life right along with 3rd pregnancy and COVID-19. The resounding theme your ambition is possible but right now slow the f**K down. The grind will come, lets focus on building the foundation.
Anyone you decide to let train you postpartum, if they're only feedback is kegels, listen to your body and intense core exercises - let that be a red flag. They are not for you right now.
Let's elaborate on the concept of listen to your body, You may hear your body but as athletes we've been trained for selective hearing. Therefore, you need to be trained for what to "listen to/feel".
Your focus in the beginning is on your breathing technique, ability to recruit and RELAX the pelvic floor muscles, recognizing if you have a diastasis recti and the signs that you are ready/not ready for a movement. We all have different postpartum experiences and vaginas this is why my number one recommendation is to get a PFT to determine what you and yours needs. This will compliment your postpartum training however that looks.
Brianna Battles placed this phrase in my mind and I'm not letting it go, "Athleticism doesn't end where motherhood begins." check her out @pregnant.postpartum.athlete. This quote really resonates with me. I struggled to find examples of the return to athleticism in the way I wanted it. Well I'm here to show you the process and to say it exists, I intend to create a circle with other postpartum athletes who've proven so and empower all moms with the knowledge to make THEIR educated decision for their season and body.
- Shayla Dena'